Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm

Summary:. Vasospastic disorders in the hand have been treated with surgical sympathectomy and recently with botulinum toxin A (BTX) injections in the palm. The purpose of this study was to evaluate if it is possible to obtain precise administration of BTX around the radial artery using a single ultr...

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Main Authors: Sven Weum, MD, PhD, Louis de Weerd, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2018-07-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001836
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author Sven Weum, MD, PhD
Louis de Weerd, MD, PhD
author_facet Sven Weum, MD, PhD
Louis de Weerd, MD, PhD
author_sort Sven Weum, MD, PhD
collection DOAJ
description Summary:. Vasospastic disorders in the hand have been treated with surgical sympathectomy and recently with botulinum toxin A (BTX) injections in the palm. The purpose of this study was to evaluate if it is possible to obtain precise administration of BTX around the radial artery using a single ultrasound-guided injection. We present a novel technique using 1 single ultrasound-guided BTX injection around the radial artery to treat vasospastic symptoms. Ten patients were included in a pilot study. All patients were referred by a rheumatologist after been diagnosed with primary or secondary Raynaud. Under ultrasound guidance, BTX was injected around the radial artery and its comitant veins 3–5 cm proximal to the wrist. Ultrasound-guided injection of BTX allowed for a precise distribution of BTX into the perivascular space of the radial artery and its comitant veins. Intravascular injection could easily be excluded. One patient reported temporary reduced grip strength, most likely due to leakage of BTX to the flexor pollicis longus muscle. No other complications were registered. All patients reported reduced number of vasospastic episodes, warmer hands, and reduced pain. Ultrasound-guided injection enables precise administration of BTX in the space surrounding the radial artery and its comitant veins. This novel approach could be a promising treatment for vasospastic disorders of the hands in patients with primary and secondary Raynaud.
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spelling doaj.art-deabe411a309484f806eaf6ff4256ae52022-12-21T21:14:40ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742018-07-0167e183610.1097/GOX.0000000000001836201807000-00012Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat VasospasmSven Weum, MD, PhD0Louis de Weerd, MD, PhD1From the * Department of Clinical Medicine, Medical Imaging Research Group, UiT The Arctic University of Norway, Tromsø, NorwayFrom the * Department of Clinical Medicine, Medical Imaging Research Group, UiT The Arctic University of Norway, Tromsø, NorwaySummary:. Vasospastic disorders in the hand have been treated with surgical sympathectomy and recently with botulinum toxin A (BTX) injections in the palm. The purpose of this study was to evaluate if it is possible to obtain precise administration of BTX around the radial artery using a single ultrasound-guided injection. We present a novel technique using 1 single ultrasound-guided BTX injection around the radial artery to treat vasospastic symptoms. Ten patients were included in a pilot study. All patients were referred by a rheumatologist after been diagnosed with primary or secondary Raynaud. Under ultrasound guidance, BTX was injected around the radial artery and its comitant veins 3–5 cm proximal to the wrist. Ultrasound-guided injection of BTX allowed for a precise distribution of BTX into the perivascular space of the radial artery and its comitant veins. Intravascular injection could easily be excluded. One patient reported temporary reduced grip strength, most likely due to leakage of BTX to the flexor pollicis longus muscle. No other complications were registered. All patients reported reduced number of vasospastic episodes, warmer hands, and reduced pain. Ultrasound-guided injection enables precise administration of BTX in the space surrounding the radial artery and its comitant veins. This novel approach could be a promising treatment for vasospastic disorders of the hands in patients with primary and secondary Raynaud.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001836
spellingShingle Sven Weum, MD, PhD
Louis de Weerd, MD, PhD
Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
Plastic and Reconstructive Surgery, Global Open
title Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
title_full Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
title_fullStr Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
title_full_unstemmed Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
title_short Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
title_sort ultrasound guided sympathetic block of the radial artery with botulinum toxin to treat vasospasm
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001836
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